FDA Blood Donation Guidelines May Remove Gendered Language

The FDA, on Friday, January 27, released a draft of proposed recommendations for updating the criteria of eligible blood donors. Under the current rules, established in 2020 as a response to the COVID-19 pandemic, a man who has had sex with one other man within the previous 90 days in ineligible to donate blood, while a man who had multiple female partners in that same 90-day period would still be eligible.

This is a positive change from the 2014 guidelines that required MSM to remain celibate for a year, and leaps and bounds ahead of the guidelines before that, which permanently banned men who had ever had sexual contact with another man from donating, but the current rules are still inherently stigmatizing and homophobic.

The recommendations would make two major changes, if implemented. The first major change is that MSM will no longer be required to stay celibate for any length of time to donate blood. Instead, the recommendations would focus on sexual acts. If a person of any gender has had a new sexual partner in the last 90 days and has had anal sex in that same time frame, they would be deferred from donation for 90 days. This goes for anyone who has had two or more sexual partners and anal sex within the last 90 days. The new guidelines would mean that people other than gay men who engage in anal sex, which carries more risk of transmitting bloodborne pathogens than other sexual acts, would be barred from donating blood temporarily.

This A) closes a loophole in which a woman who engages in risky sexual behavior (but not with a MSM) or a man who engages in risky sexual behavior (but not with other men) would be allowed to donate blood; and B) allows MSM to live life as typical sexually active adults without worrying that they will be unable to donate blood.

In addition, the proposed changes would bar anyone taking antiretroviral drugs such as PrEP from blood donation for three months if taken orally, and two years if injected, as these drugs lower the viral load low enough that they could be undetectable in a viral test, but could potentially still infect a blood recipient. Despite U=U (Undetectable=Untransmissible) becoming the accepted truth about HIV transmission, one can only assume that the FDA is acting out of an abundance of caution. The FDA also warned that those on PrEP should not stop taking it to be allowed to donate blood.

These new guidelines may still disproportionately affect MSM, as they are more likely than their straight counterparts to have anal sex, and are the primary receivers of antiretroviral drugs, but overall, these proposed changes should be considered a win for equality and destigmatization.